Differential Diagnosis for Ear Pressure and Fullness after a Cold

Single Most Likely Diagnosis

• Eustachian Tube Dysfunction (ETD): This condition is a common complication of upper respiratory infections like the common cold. The Eustachian tube connects the middle ear to the back of the nose and throat, helping to regulate air pressure in the ear. During a cold, the tube can become blocked or inflamed, leading to feelings of ear fullness and pressure.

Other Likely Diagnoses

• Middle Ear Effusion (MEE): Also known as serous otitis media, this condition involves fluid accumulation in the middle ear without signs of acute infection. It can occur after a cold and cause symptoms of ear fullness and pressure.
• Acute Otitis Media (AOM): An infection of the middle ear that can follow a cold. Symptoms include ear pain, fever, and sometimes a feeling of fullness or pressure in the ear.
• Sinusitis: Inflammation or infection of the sinuses can cause referred pain and pressure sensations in the ears, especially if the Eustachian tube is affected.

Do Not Miss Diagnoses

• Mastoiditis: A serious infection of the mastoid bone in the skull, located behind the ear. It can be a complication of untreated or inadequately treated otitis media and requires prompt medical attention.
• Labyrinthitis: An inner ear disorder characterized by inflammation of the part of the inner ear responsible for balance (vestibular system) and hearing. It can cause severe vertigo, hearing loss, and ear pressure.
• Petrous Apicitis: A rare but serious infection of the petrous part of the temporal bone, which can lead to severe complications if not treated promptly.

Rare Diagnoses

• Cholesteatoma: A type of skin cyst located in the middle ear, which can be a complication of chronic otitis media or Eustachian tube dysfunction. It's rare but can cause significant damage to the ear if left untreated.
• Temporal Bone Fracture: Although not directly related to having a cold, if the ear pressure and fullness are accompanied by a history of trauma, a fracture of the temporal bone should be considered, as it can cause similar symptoms.
• Relapsing Polychondritis: A rare autoimmune disorder that can cause cartilage inflammation, including the cartilage in the ears, leading to ear pain, redness, and possibly feelings of fullness or pressure.